New Hope For Burnout Syndrome in the ICU

1/11/2018

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Expert

​By
Andy Nellis​

Inside every hospital, past the winding halls and busy
reception desks, there lies a special set of rooms reserved for only the most
critically ill patients. It’s a place most people would never wish to visit and
yet for those who are admitted, it may be a lifesaver. It’s the Intensive Care
Unit, or ICU, and it is staffed by some of the most highly trained doctors and
nurses found anywhere in medicine. But for those who work there a normal
day on the job is hectic, demanding, and beyond stressful because the every
day the lives of their patients literally hang in the balance. So, with so much
on the line, it’s no wonder why those working in the ICU feel a unique strain.

It’s a strain that’s experienced all throughout
the unit, by doctors and staff alike, but it’s particularly sharp for those
working closest to the patients – the nurses. Theirs is a role anyone would
consider demanding since they must attend to the patient’s every need, doing
everything from answering medical questions to consulting with family
members, to carrying out the many treatments prescribed by the physicians. And
performing this enormous duty subjects those nurses to some of the most jarring
and psychologically taxing experiences in healthcare, leaving many feeling
exhausted, frustrated, and unsure about their career choice. This in turn can
cause them to leave their job after only a few short years.

This phenomenon is called Burnout Syndrome, or
BOS, and it affects around 80 percent of ICU nurses according to an article published in
the journal Depression and Anxiety​. ​This
problem has wide-reaching effects
on both patient care and clinical operations, which is why a team of researchers at the
University of Colorado School of Medicine are exploring ways to address BOS
through innovative research.

The research team, led by Marc Moss M.D. of the
Pulmonary and Critical Care Division at the University of Colorado Denver, aims
to help ICU nurses combat burnout syndrome through a therapeutic intervention
called Mindfulness-Based Cognitive Therapy (MBCT). Their study, based on the
work of the University of Toronto’s Dr. Zindel Segal, uses a combination of
mindfulness practices and meditation to provide ICU nurses with constructive
methods for coping with the strain of working in the ICU. Participation
involves four sessions where the nurses are led through mindfulness exercises
designed to refocus their awareness on the present and to navigate their way
through negative, automatic thoughts. It’s a lifestyle-change intervention that
has been applied to treat depression, anxiety, and Posttraumatic Stress
Disorder (PTSD) in the past. The team hopes their MBCT adaptation will help ICU
nurses better manage symptoms of Burnout Syndrome, and develop a lifestyle of
self-care and self-compassion in the context of their work.

“Imagine a 29-year-old otherwise healthy
person,” Dr. Moss explains, “who is admitted to the hospital because of the
flu, develops Acute Respiratory Distress Syndrome (ARDS) and dies. That’s not
easy to deal with… It’s sad, it’s tragic.” And yet it’s something nurses have
to deal with on a regular basis, and listening to Dr. Moss, it becomes very
clear how difficult it is for ICU nurses, and all ICU providers and staff to
handle such ongoing human trauma. Most ICU nurses are never trained to
deal with the emotional fallout, and even if they are, the recurring stress
associated with their position requires a certain level of resiliency that
allows these nurses to respond healthily to even the most challenging medical
experiences. Resiliency can be taught, and Dr. Moss hopes to address this lack
of training through the MBCT intervention. “we need to provide the proper
support and training so that critical care healthcare professionals can
continue to enjoy their jobs and deliver the best care to their patients.”

While the
study is still in its pilot phase it is already garnering attention. This
past July, Dr. Moss lectured on the subject to the National Academy of Medicine’s Action
Collaborative on Clinician Well-Being and Resilience. The first
cohort of MBCT sessions for the study began this summer (2017), and if the
intervention proves effective, the team aims to launch a nation-wide program,
providing new hope to the future of the ICU, and the nurses who work there.